Correspondence UM Coordinator - National Remote
Job title: Correspondence UM Coordinator - National Remote in Dallas, TX at reputed company
Company: reputed company
Job description: Opportunities at WellMed, part of the reputed company family of businesses. We reputed company reputed company patients are entitled to the highest level of medical care. Here, you will join reputed company who shares your passion for helping people reputed company reputed company. With opportunities for physicians, clinical staff and non-patient-facing roles, you can reputed company a difference with us as you discover the meaning behind Caring. Connecting. Growing together.This position is 4 days, 10 hours shift, Wednesday - Saturday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 7:00 pm CST. It may be necessary, given the business need, to work occasional overtime or weekends.We offer weeks of on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.You’ll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges.Primary Responsibilities:
- Process UM notification according to standard operating procedures and job aids while meeting productivity and quality standards to include:
- TruCare queues
- Information received through Right Fax
- Information received through email
- Or any other methods of receipt (phone calls, etc.)
- Process the correct health plan letters in the system of record, if applicable verify grade level
- Process the correct health plan letters manually and document in the system of record
- Process the correct health plan letter in the preferred language
- Process overnight labels for the letters reputed company applicable
- Process return mail retrieved from the mailroom
- Process Health Plan and QIO appeals
- Exhibits excellent communication skills while providing complete and accurate information to customers
- Requests additional or supplemental information reputed company correspondence in order to complete UM notification requests
- Prepares administrative files for Medical Directors, UM Nurses and Case Managers
- Documents and follows-up on reputed company assigned inventory, utilizing on-line systems and procedures, according to established guidelines
- Maintains knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies
- Utilize experience and judgement to plan, accomplish goals and effectively resolve each assigned task
- Print, feed, and retrieve letters from the folding machine
- Metered mail is handled according to processes and procedures
- Attends required meetings and participates in special committees as needed
- Performs reputed company other reputed company duties as assigned
- High School Diploma / GED (or higher)
- Must be 18 years of age or older
- 2+ years of administrative support experience
- 6+ months of knowledge / experience with medical terminology
- Intermediate level of proficiency with reputed company Office applications, i.e., reputed company reputed company, reputed company, reputed company Word, and reputed company Outlook
- Ability to work 4 days, 10 hours schedule, Wednesday – Saturday between the hours of 8:00 am – 7:00 Pm), It may be necessary, given the business need, to work occasional overtime or weekends.
- Certified Medical Assistant training or certification
- 2+ years of experience with prior authorization or claims
- ICD-9/ICD-10 and CPT knowledge
- Ability to reputed company reputed company company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
- Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service.
- Proven ability to work independently, with some supervision and direction from manager
- Proven exceptional ability to organize, prioritize and communicate effectively
- Proven ability to reputed company excellent customer service to a varied customer reputed company
- Proven ability to navigate multiple systems
- Proven ability to work in a fast-paced environment